﻿<%@ Page Language="C#" MasterPageFile="~/travel-insurance/proposalforms/TravelInsuranceProposalMasterPage.master" Async="true"
    Title="Travel Insurance - CompareXpress Singapore" AutoEventWireup="true" CodeFile="chinataiping_proposal_form.aspx.cs"
    Inherits="travel_insurance_chinataiping_proposal_form" %>

<%@ Register Src="~/controls/usrPhoneNo.ascx" TagName="usrPhoneNo" TagPrefix="uc1" %>
<%@ Register Src="~/controls/usrDate.ascx" TagName="usrDate" TagPrefix="uc2" %>
<%@ Register Src="~/controls/usrIdType.ascx" TagName="usrIdType" TagPrefix="uc3" %>
<%@ Register Src="~/controls/usrIdNumber.ascx" TagName="usrIdNumber" TagPrefix="uc4" %>
<%@ Register Src="~/controls/usrCompanyLogoByServices.ascx" TagName="usrCompanyLogoByServices"
    TagPrefix="uc5" %>
<%@ Register Src="~/controls/usrSalutation.ascx" TagName="usrSalutation" TagPrefix="uc6" %>
<%@ Register Src="~/controls/usrNationality.ascx" TagName="usrNationality" TagPrefix="uc7" %>
<%@ Register Src="~/controls/usrGender.ascx" TagName="usrGender" TagPrefix="uc8" %>
<%@ Register Src="~/controls/usrRelationship.ascx" TagName="usrRelationship" TagPrefix="uc9" %>
<%@ Register Src="~/controls/usrTraveller.ascx" TagName="usrTraveller" TagPrefix="uc10" %>
<%@ Register Src="~/controls/usrNoJS.ascx" TagName="usrNoJS" TagPrefix="ucNoJS" %>
<%@ Register Src="~/controls/usrCXAds.ascx" TagName="usrCXAds" TagPrefix="ucAds" %>
<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" runat="Server">

    <script src="../../controls/CE_Date.js" type="text/javascript"></script>

    <script src="../../controls/IdNumber.js" type="text/javascript"></script>

    <script src="../../includes/PostCode.js" type="text/javascript"></script>

    <div id="container">
    
        <div id="nav_top">
            <div class="left pad_8yr">
                <a href="/travel-insurance/TAresultsquotesOne.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a></div>
            <div class="right pad_8yr">
                <img src="/images/forms_proposal/nav/logo_comparexpress.png" alt="CompareXpress" /></div>
        </div>
        
        <ucNoJS:usrNoJS ID="usrNoJS1" runat="server" />
        <asp:ScriptManager ID="ScriptManager1" runat="server"></asp:ScriptManager>
         <div id="divContent">
            <div id="contentBody">
                <div id="header">
                    <div class="seperator"></div>
                    <div class="right" style="width: 240px">
                        <div class="quotesum_button">
                            <img src="/images/forms_proposal/button/quotesum.png" width="240" height="73" alt="Quote Summary" /></div>
                    </div>
                    <h1>Online Travel Insurance Proposal Form - <asp:Label ID="lblProvider" runat="server"></asp:Label></h1>
                    <div class="seperator"></div>
                    <div class="quotesum">
                        <div class="top"></div>
                        <div id="divQuoteSummery" class="body pad_15x">
                            <!-- QUOTE SUMMARY | Start -->
                            <div class="w21per left pad_25xr">
                                <h1>Quote Reference Number</h1>
                                <p><asp:Label ID="lblQref" runat="server"></asp:Label></p>
                                <h1>Type of Travel:</h1>
                                <p>
                                    <asp:Label ID="lblCoverageType" runat="server"></asp:Label><asp:Label ID="lblCover" runat="server" 
                                        Visible="false"></asp:Label><asp:Label ID="lblCoverage" runat="server" Visible="false"></asp:Label>
                                </p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>Country Traveling to (one or furthest):</h1>
                                <p><asp:Label ID="lblDestination" runat="server"></asp:Label><asp:Label ID="lblTrip" runat="server" Visible="false"></asp:Label></p>
                                <h1>Period of Insurance:</h1>
                                <p>
                                    <asp:Label ID="lblPeriodOfCoverage" runat="server"></asp:Label>
                                    <asp:Label ID="lblDuration" runat="server" Visible="false"></asp:Label><asp:Label
                                        ID="lblStart" runat="server" Visible="false"></asp:Label><asp:Label ID="lblEnd" runat="server"
                                            Visible="false"></asp:Label>
                                </p>
                            </div>
                            <div class="w21per left pad_25xr">
                                <h1>Type of Plan:</h1>
                                <p>
                                    <asp:Label ID="lblPolicyType" runat="server"></asp:Label><asp:Label ID="lblAdultAge"
                                        runat="server" Visible="false"></asp:Label><asp:Label ID="lblChildAge" runat="server"
                                            Visible="false"></asp:Label>
                                </p>
                                <h1>No. of Traveller/s:</h1>
                                <p><asp:Label ID="lblNoOfTravellers" runat="server"></asp:Label><input id="inNoOfTravellers" runat="server" type="hidden" /></p>
                            </div>
                            <script type="text/javascript">
                                IncreaseProgress(20);
                            </script>
                            <div class="w21per left pad_25xr">
                                <h1>&nbsp;</h1>
                                <p>&nbsp;</p>
                                <h1>Total Premium (w/ GST):</h1>
                                <p><asp:Label ID="lblTotalPremium" runat="server"></asp:Label></p>
                            </div>
                            <!-- QUOTE SUMMARY | End   -->
                        </div>
                        <div class="bottom"></div>
                    </div>
                </div>
                
                <div class="seperator"></div>
                
                <script type="text/javascript">
                    IncreaseProgress(25);
                </script>
                
                <div id="body"></div>
                <div id="divValidationSummary">
                    <asp:ValidationSummary ID="vstravelinsurance" runat="server" CssClass="errorSummary"
                        ValidationGroup="travel_insurance" HeaderText="Oops please complete the form" />
                </div>
                <div class="form">
                    <div class="top">
                        <div class="left">
                            <div class="pad_10t pad_35xl white">Online Travel Insurance Proposal Form</div>
                        </div>
                        <div class="right"></div>
                    </div>
                    <div class="body">
                        <div class="inner">
                            <div class="pad_20x10y">
                                <div class="norm">
                                    <div class="top_t"></div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <p>
                                                <b>Important Notice: </b><br />
                                                1. Pursuant to Section 25(5) of the Insurance Act (Cap. 142), or any subsequent amendments
                                                thereof, you are to disclose in this Application, fully and faithfully, all the
                                                facts you know or ought to know, otherwise the Policy issued hereunder may be void
                                                and you may receive nothing from the Policy.<br />
                                                2. This Insurance Policy will not be in force until the proposal is accepted and the premium is being paid and received in full by the company.
                                                <br />
                                                3. Pre-existing medical conditions are not covered by the Policy.<br />
                                                <span style="color:Red; font-weight:bold;">**</span> Main insured must be a Singapore resident, Singapore PR or Work
                                                Permit Holder and be at least 18 years of age. </p>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>

                                <div class="hilite">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x">
                                        <h1>Customer Personal Details</h1>
                                        <div class="seperator"></div>
                                        <div class="w43per left">
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Salutation:</div>
                                                <div class="left">
                                                   <uc6:usrSalutation ID="ddlSalutation" runat="server" ValidationGroup="travel_insurance" />
                                                </div>                                                
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Surname:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtSurname" runat="server" Width="200px"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvSurname" runat="server" ControlToValidate="txtSurname"
                                                        CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Given/First Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtFirstname" runat="server" Width="200px"></asp:TextBox>
                                                    <asp:HyperLink ID="hplEditProfile" Visible="false" NavigateUrl="~/User/EditProfile.aspx?redir=~/travel-insurance/applicants_details.aspx"
                                                        Font-Size="Smaller" Text="Edit Profile" runat="server"></asp:HyperLink>
                                                    <asp:RequiredFieldValidator ID="rfvFirstname" runat="server" ControlToValidate="txtFirstname"
                                                        CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>                            
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> E-mail:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtEmailAddress" runat="server" Width="200px"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvEmailAddress" runat="server" ControlToValidate="txtEmailAddress"
                                                        Display="Dynamic" CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revEmailAddress" runat="server" ControlToValidate="txtEmailAddress"
                                                        CssClass="validationErrorControl" ErrorMessage="" ValidationExpression="\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*"
                                                        ValidationGroup="travel_insurance"></asp:RegularExpressionValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div>
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Nationality:</div>
                                                <div class="left">
                                                    <uc7:usrNationality ID="ddlNationality" runat="server" ErrorMessage="" ValidationGroup="travel_insurance" />
                                                </div>
                                            </div>
                                        </div>
                                        <div class="w56per left">
                                            <asp:UpdatePanel ID="UpdatePanel1" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPostCode">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Postcode:
                                                        </div>
                                                        <asp:TextBox ID="txtPostCode" size="8" onkeypress="restrictToNumbers(event)" AutoPostBack="true"
                                                            OnTextChanged="txtPostCode_TextChanged" runat="server" MaxLength="6" Width="80px"></asp:TextBox>
                                                        <asp:ImageButton ID="ibtPostCode" runat="server" CssClass="button" align="absmiddle"
                                                            OnClick="ibtPostCode_Click" Width="108" ValidationGroup="PostCode" AlternateText="Get Address"
                                                            ImageUrl="~/images/forms_proposal/button/getaddress.png" />
                                                        <asp:UpdateProgress runat="server" ID="uplUpProgress" DisplayAfter="500">
                                                            <ProgressTemplate>
                                                                <span style="position: absolute; text-align: right; width: 390px;">
                                                                    <img src="../../images/loading7.gif" id="ldPostCode" alt="loading" />
                                                                </span>
                                                            </ProgressTemplate>
                                                        </asp:UpdateProgress>
                                                        <asp:RequiredFieldValidator ID="rfvPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="PostCode" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                        <asp:RequiredFieldValidator ID="rfvPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtPostCode"></asp:RequiredFieldValidator>
                                                        <asp:RegularExpressionValidator ID="revPostCode" runat="server" CssClass="validationErrorControl"
                                                            Display="Dynamic" ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{6}"
                                                            ControlToValidate="txtPostCode"></asp:RegularExpressionValidator>
                                                    </div>
                                                    <div runat="server" visible="false" id="divAddressList">
                                                        <div class="h10"></div>
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            Please choose your address
                                                        </div>
                                                        <asp:DropDownList ID="ddlAddressList" Width="320px" AutoPostBack="true" runat="server" OnSelectedIndexChanged="ddlAddressList_SelectedIndexChanged">
                                                        </asp:DropDownList>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                            <div class="h10"></div>
                                            <div id="divUnitNo">
                                                <div class="w180 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Unit Number:
                                                </div>
                                                <asp:TextBox ID="txtUnit1" MaxLength="10" runat="server" size="8"></asp:TextBox>-
                                                <asp:RequiredFieldValidator ID="rfvUnit1" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtUnit1"></asp:RequiredFieldValidator>
                                                <asp:TextBox ID="txtUnit2" MaxLength="10" runat="server" size="8"></asp:TextBox>
                                                <asp:RequiredFieldValidator ID="rfvUnit2" runat="server" CssClass="validationErrorControl"
                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtUnit2"></asp:RequiredFieldValidator>
                                            </div>
                                            <div class="h10"></div>
                                            <asp:UpdatePanel ID="UpdatePanel2" runat="server">
                                                <ContentTemplate>
                                                    <div id="divPCAddress">
                                                        <div class="w180 left align_right pad_6t pad_7xr">
                                                            <span class="red">*</span> Address:
                                                        </div>
                                                        <span id="divAddress"></span>
                                                        <asp:TextBox ID="txtAddress" runat="server" TextMode="MultiLine" MaxLength="120"
                                                            Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvAddress" runat="server" CssClass="validationErrorControl"
                                                            ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtAddress"></asp:RequiredFieldValidator>
                                                    </div>
                                                </ContentTemplate>
                                            </asp:UpdatePanel>
                                        </div>
                                        <div class="clear"></div>
                                        <div class="h10"></div>
                                        <div style="border: 1px solid #ccc; width: 912px; background: #d2d2d2;">
                                            <div class="h10"></div>
                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                Contact Info:</div>
                                            <div class="w190 note left">
                                                <span class="red">*</span> Mobile Number<br />
                                                <uc1:usrPhoneNo ID="txtMobileNo" IsEnabled="true" IsRequired="true" PhoneNoRequireErrorMessage="Require mobile number."
                                                    PhoneNoErrorMessage="Mobile phone number should 8 digits." PhoneNoValidErrorMessage="Invalid mobile phone number."
                                                    runat="server" ValidationGroup="travel_insurance" />
                                            </div>
                                            <div class="w190 note left">
                                                Home Phone Number<br />
                                                <uc1:usrPhoneNo ID="txtResidentialPhoneNo" runat="server" ValidationGroup="travel_insurance"
                                                    IsRequired="False" PhoneNoValidErrorMessage="Invalid home phone number." />
                                            </div>
                                            <div class="w190 note left">
                                                Office Phone Number<br />
                                                <uc1:usrPhoneNo ID="txtOfficeNo" runat="server" ValidationGroup="travel_insurance"
                                                    IsRequired="False" />
                                            </div>
                                            <div class="h10"></div>
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>
                                
                                <div class="seperator"></div>

                                <script type="text/javascript">
                                    IncreaseProgress(40);
                                </script>
                                
                                <div class="hilite" id="divTravellersInsured">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x" id="divInsured">
                                        <h1>Insured Details</h1>
                                        <div class="seperator"></div>
                                        <div id="divIndividual" runat="server">                                 
                                            <div class="w43per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Insured:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNameOfInsured" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNameOfInsured" runat="server" ControlToValidate="txtNameOfInsured"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOB" runat="server" ValidationGroup="travel_insurance" IsRequired="True" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPass" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPass" runat="server" ControlToValidate="txtNRICPass"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                            </div>
                                        </div> 
                                        <div id="divWithspouse" runat="server">                                 
                                            <div class="w43per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Insured:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtInsured" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvInsured" runat="server" ControlToValidate="txtInsured"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBinsured" runat="server" ValidationGroup="travel_insurance" IsRequired="True" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassInsured" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassInsured" runat="server" ControlToValidate="txtNRICPassInsured"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="w56per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Partner/Spouse:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouse" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouse" runat="server" ControlToValidate="txtSpouse"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBSpouse" runat="server" ValidationGroup="travel_insurance" IsRequired="True" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassSpouse" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassSpouse" runat="server" ControlToValidate="txtNRICPassSpouse"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div style="display: none;">
                                                    <div>
                                                        <asp:TextBox ID="txtNRICwidSpouse" runat="server" Text="Valid"></asp:TextBox>
                                                        <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtNRICwidSpouse"
                                                            ValidationGroup="travel_insurance" ID="csvNRIC" ClientValidationFunction="Check2NRICValid"
                                                            OnServerValidate="Check2NRICValid" runat="server" ErrorMessage="Applicant IC/Passport and Spouse IC/Passport is the same."
                                                            Text=""></asp:CustomValidator>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div id="divFamily" runat="server">                                 
                                            <div class="w43per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Insured:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtInsuredFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvInsuredFamily" runat="server" ControlToValidate="txtInsuredFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBInsuredFamily" runat="server" ValidationGroup="travel_insurance" IsRequired="True" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassInsuredFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassInsuredFamily" runat="server" ControlToValidate="txtNRICPassInsuredFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div style="display:none;">
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Number of children travelling:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNoOfChild" runat="server" Width="200px" Text="0"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNoOfChild" runat="server" ControlToValidate="txtNoOfChild"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                        <asp:TextBox ID="txtNoOfAdult" runat="server" Width="200px" Text="0"></asp:TextBox>
                                                        <asp:TextBox ID="txtNoOfTravellers" runat="server" Width="200px" Text="0"></asp:TextBox>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="w56per left">
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Name of Partner/Spouse:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtSpouseFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvSpouseFamily" runat="server" ControlToValidate="txtSpouseFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> Date of Birth:</div>
                                                    <div class="left">
                                                        <uc2:usrDate ID="usrDOBSpouseFamily" runat="server" ValidationGroup="travel_insurance" IsRequired="True" />
                                                    </div>
                                                </div>
                                                <div class="h10"></div>
                                                <div>
                                                    <div class="w180 left align_right pad_6t pad_7xr">
                                                        <span class="red">*</span> NRIC/Passport number:</div>
                                                    <div class="left">
                                                        <asp:TextBox ID="txtNRICPassSpouseFamily" runat="server" Width="200px"></asp:TextBox>
                                                        <asp:RequiredFieldValidator ID="rfvNRICPassSpouseFamily" runat="server" ControlToValidate="txtNRICPassSpouseFamily"
                                                            CssClass="validationErrorControl" ErrorMessage="" ValidationGroup="travel_insurance"></asp:RequiredFieldValidator>
                                                    </div>
                                                </div>
                                                <div style="display: none;">
                                                    <asp:TextBox ID="txtNRICwithFamily" runat="server" Text="Valid"></asp:TextBox>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtNRICwithFamily"
                                                        ValidationGroup="travel_insurance" ID="cvNRICfamily" ClientValidationFunction="Check2NRICValidFamily"
                                                        OnServerValidate="Check2NRICValidFamily" runat="server" ErrorMessage="Applicant IC/Passport and Spouse IC/Passport is the same."
                                                        Text=""></asp:CustomValidator>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="clear"></div>
                                    </div>
                                    <div class="bottom"></div>
                                    
                                </div><div class="seperator"></div>
                                <script type="text/javascript">
                                    IncreaseProgress(50);
                                </script>
                                <asp:Panel ID="pnlAdultsParticulars" runat="server" Width="100%">
                                <div class="hilite" id="divAdults">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Additional Adult's Details</h1>
                                            <asp:Panel ID="pnlAdult1" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Adult 1</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divAdultName1">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtAdultName1" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvAdultName1" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtAdultName1"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revAdultName1" runat="server" ControlToValidate="txtAdultName1"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlAdultDOB1" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlAdultIdNumber1" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlAdult2" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Adult 2</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divAdultName2">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtAdultName2" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvAdultName2" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtAdultName2"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revAdultName2" runat="server" ControlToValidate="txtAdultName2"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlAdultDOB2" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlAdultIdNumber2" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>
                                <script type="text/javascript">
                                    IncreaseProgress(60);
                                </script>
                                <asp:Panel ID="pnlChildsParticulars" runat="server" Width="100%">
                                <div class="hilite" id="divChilds">
                                        <div class="top">
                                        </div>
                                        <div class="body_in pad_15x">
                                            <h1>
                                                Child's Details</h1>
                                            <asp:Panel ID="pnlChild1" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 1</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName1">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName1" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName1" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName1"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName1" runat="server" ControlToValidate="txtChildName1"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB1" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber1" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild2" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 2</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName2">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName2" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName2" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName2"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName2" runat="server" ControlToValidate="txtChildName2"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB2" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber2" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild3" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 3</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName3">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName3" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName3" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName3"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName3" runat="server" ControlToValidate="txtChildName3"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB3" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber3" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild4" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 4</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName4">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName4" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName4" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName4"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName4" runat="server" ControlToValidate="txtChildName4"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB4" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber4" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild5" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 5</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName5">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName5" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName5" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName5"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName5" runat="server" ControlToValidate="txtChildName5"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB5" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber5" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                            <asp:Panel ID="pnlChild6" runat="server" Width="100%">
                                                <div class="seperator">
                                                </div>
                                                <div>
                                                    <h3>
                                                        Child 6</h3>
                                                    <div class="h10">
                                                    </div>
                                                    <div class="w43per left">
                                                        <div id="divChildName6">
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Name:</div>
                                                            <div class="left pad_6t">
                                                                <asp:TextBox ID="txtChildName6" MaxLength="50" runat="server" Width="200px"></asp:TextBox>
                                                                <asp:RequiredFieldValidator ID="rfvChildName6" runat="server" CssClass="validationErrorControl"
                                                                    ErrorMessage="" ValidationGroup="travel_insurance" ControlToValidate="txtChildName6"></asp:RequiredFieldValidator>
                                                                <asp:RegularExpressionValidator ID="revChildName6" runat="server" ControlToValidate="txtChildName6"
                                                                    ValidationExpression="^[a-zA-Z''-'\s]{1,50}$" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                                    Text="" ErrorMessage=""></asp:RegularExpressionValidator>
                                                            </div>
                                                        </div>
                                                        <div class="h10"></div>
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> Date of Birth:</div>
                                                            <div class="left">
                                                                <uc2:usrDate ID="ddlChildDOB6" runat="server" ValidationGroup="travel_insurance" IsEnabled="false" />
                                                            </div>
                                                        </div>
                                                    </div>
                                                    <div class="w56per left">
                                                        <div>
                                                            <div class="w180 left align_right pad_6t pad_7xr">
                                                                <span class="red">*</span> NRIC Number:</div>
                                                            <div class="left">
                                                                <uc4:usrIdNumber ID="ddlChildIdNumber6" runat="server" ValidationGroup="travel_insurance" />
                                                            </div>
                                                        </div>
                                                        <div class="clear">
                                                        </div>
                                                    </div>
                                                </div>
                                            </asp:Panel>
                                        </div>
                                        <div class="bottom">
                                        </div>
                                    </div>
                                    <div class="seperator">
                                    </div>
                                </asp:Panel>

                                <script type="text/javascript">
                                    IncreaseProgress(70);
                                </script>
                                
                                <div class="hilite" style="display: " id="divPaymentModeHeader">
                                    <div class="top"></div>
                                    <div class="body_in pad_15x" id="divPaymentMode">
                                        <h1>Payment Mode</h1>
                                        <div class="seperator"></div>
                                        I / We authorised <b>China Taiping Insurance</b> to debit the premium
                                        amount due in connection with above insurance policy to my nominated Credit Card
                                        Account. Where a third party Credit Card is used, I declared that the cardholder
                                        has authorised and consented to its use.
                                        <div class="seperator"></div>
                                        <div id="divCreditcard" style="display: ;">
                                            <div id="divNameoftheCard">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Cardholder's Name:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtNameoftheCard" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvNameoftheCard" ControlToValidate="txtNameoftheCard"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divIssuingBank">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Issuing Bank:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtIssuingBank" MaxLength="50" runat="server" size="25"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvIssuingBank" ControlToValidate="txtIssuingBank"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardNo">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Credit Card Number:</div>
                                                <div class="left">
                                                    <asp:TextBox ID="txtCardNo1" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo2" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo3" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:TextBox ID="txtCardNo4" runat="server" MaxLength="4" size="8"></asp:TextBox>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo1" ControlToValidate="txtCardNo1" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo1" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo1"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo2" ControlToValidate="txtCardNo2" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo2" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo2"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo3" ControlToValidate="txtCardNo3" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo3" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo3"></asp:RegularExpressionValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardNo4" ControlToValidate="txtCardNo4" ErrorMessage=""
                                                        ValidationGroup="travel_insurance" CssClass="validationErrorControl"
                                                        runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RegularExpressionValidator ID="revCardNo4" runat="server" CssClass="validationErrorControl"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" ValidationExpression="[0-9]{4}"
                                                        ControlToValidate="txtCardNo4"></asp:RegularExpressionValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCreditCardValid"
                                                        ValidationGroup="travel_insurance" ID="csvCreditCardValid" runat="server" ErrorMessage="Credit Card number not valid."
                                                        Text="" OnServerValidate="csvCreditCardValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCreditCardValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardExpiry">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Expiry Date:</div>
                                                <div class="left">
                                                    <asp:DropDownList ID="ddlCardExpiryMonth" runat="server">
                                                        <asp:ListItem Selected="True" Value="-1">mm</asp:ListItem>
                                                        <asp:ListItem Value="01">01</asp:ListItem>
                                                        <asp:ListItem Value="02">02</asp:ListItem>
                                                        <asp:ListItem Value="03">03</asp:ListItem>
                                                        <asp:ListItem Value="04">04</asp:ListItem>
                                                        <asp:ListItem Value="05">05</asp:ListItem>
                                                        <asp:ListItem Value="06">06</asp:ListItem>
                                                        <asp:ListItem Value="07">07</asp:ListItem>
                                                        <asp:ListItem Value="08">08</asp:ListItem>
                                                        <asp:ListItem Value="09">09</asp:ListItem>
                                                        <asp:ListItem Value="10">10</asp:ListItem>
                                                        <asp:ListItem Value="11">11</asp:ListItem>
                                                        <asp:ListItem Value="12">12</asp:ListItem>
                                                    </asp:DropDownList>
                                                    <asp:DropDownList ID="ddlCardExpiryYear" runat="server"></asp:DropDownList>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryMonth" ControlToValidate="ddlCardExpiryMonth"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" InitialValue="-1" Text=""
                                                        CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:RequiredFieldValidator ID="rfvCardExpiryYear" ControlToValidate="ddlCardExpiryYear"
                                                        ErrorMessage="" ValidationGroup="travel_insurance" InitialValue="-1" Text=""
                                                        CssClass="validationErrorControl" runat="server"></asp:RequiredFieldValidator>
                                                    <asp:CustomValidator CssClass="validationErrorControl" ControlToValidate="txtCCExpiredValid"
                                                        ValidationGroup="travel_insurance" ID="csvCCExpiredValid" runat="server" ErrorMessage="Credit Card expire not valid."
                                                        Text="" OnServerValidate="csvCCExpiredValid_ServerValidate"></asp:CustomValidator>
                                                    <span style="display: none">
                                                        <asp:TextBox ID="txtCCExpiredValid" Text="Valid" runat="server"></asp:TextBox>
                                                    </span>
                                                </div>
                                            </div>
                                            <div class="h10"></div>
                                            <div id="divCardType">
                                                <div class="w220 left align_right pad_6t pad_7xr">
                                                    <span class="red">*</span> Card Type:</div>
                                                <div class="left">
                                                    <span id="divVisa">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoVisa"
                                                            runat="server" GroupName="cardtype" />
                                                        &nbsp;<asp:Label class="pad_10xr" ID="lblVisa" runat="server" Text="VISA"></asp:Label>
                                                    </span>
                                                    <span id="divMasterCard">
                                                        <asp:RadioButton onclick="ValCheckCardType();CheckCardTypeValidationCss();" ID="rdoMasterCard"
                                                            runat="server" GroupName="cardtype" />
                                                        &nbsp;<asp:Label ID="lblMasterCard" runat="server" Text="MasterCard"></asp:Label>
                                                    </span>
                                                    <div style="display: none">
                                                        <asp:TextBox ID="txtCardType" runat="server"></asp:TextBox>
                                                    </div>
                                                    <asp:RequiredFieldValidator ID="rfvCardType" runat="server" CssClass="validationErrorControl"
                                                        Display="Dynamic" ErrorMessage="" ControlToValidate="txtCardType" ValidationGroup="travel_insurance"
                                                        Text=""></asp:RequiredFieldValidator>
                                                    <div class="clear"></div>
                                                    <em class="note">(Only VISA or Master Credit Card is acceptable for premium payment)</em>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="seperator">
                                        </div>
                                        By signing this proposal form, I am aware that any refund will be paid by cheque
                                        the Insured/Policyholder. <b>China Taiping Insurance</b> will consider
                                        all declared information as true and correct. This Credit Card payment is subject
                                        to the terms of the Credit Card Agreement.
                                    </div>
                                    <div class="bottom"></div>
                                </div>

                                <div class="seperator"></div>
                                
                                <script type="text/javascript">
                                    IncreaseProgress(80);
                                </script>
                        
                                <div class="norm" id="divDeclarationHeader">
                                    <div class="top">
                                    </div>
                                    <div class="body">
                                        <div class="pad_15x">
                                            <h1>Warranty and Declaration"</h1>
                                            <div class="seperator"></div>
                                            <div>
                                                <p>The Insured Person(s) hereby warrant and declare for themselves and on behalf of all members of the travelling party as follows:</p>
                                                <div class="h7"></div>
                                                <p>I) I/We are not travelling contrary to the advice of a Qualified Medical Practitioner or for the purpose of obtaining medical treatment.</p>
                                                <div class="h7"></div>
                                                <p>II) I/We are currently in good health, free from all physical impairment and deformity. &nbsp;&nbsp;&nbsp;&nbsp;<span
                                                    style="cursor: pointer;" onclick="showhide('divDeclaration');" class="form_i_cap">More Info
                                                    <img id='imgDeclaration' alt="Click to show/hide More Info" border="0" src="../../images/icons/sort_down.GIF" /></span></p>
                                            </div>
                                        </div>
                                        <div style="display: " id="divDeclaration" class="pad_15x">
                                            <div class="h7"></div>
                                            <p>III) I/We understand and agree that no insurance is in force until an Application is accepted by the Company and a Policy is issued pursuant thereon.</p>
                                            <div class="h7"></div>
                                            <p>IV) I/We are aware of and agree to abide by the Policy's terms, conditions and exclusions.  </p>
                                            <div class="h7"></div>
                                            <p>V) I/We agree and authorise any medical source (including hospitals and clinics), Insurance officer or any organization to release to the Company at any time any information concerning
                                            the Insured Person(s) if required.</p>
                                      
                                        </div>
                                    </div>
                                    <div class="bottom"></div>
                                </div>

                                <script type="text/javascript">
                                    IncreaseProgress(90);
                                </script>
                                
                                <div class="seperator"></div>
                                
                                <div class="center align_center" id="divFormButtons">
                                    <asp:ImageButton ID="ibtSubmit" runat="server" ValidationGroup="travel_insurance"
                                        OnClientClick="LoadValidationErrorCss();CheckOptionValidationCss();" ImageUrl="~/images/forms_proposal/button/submit.png"
                                        OnClick="ibtSubmit_Click" class="button" />
                                    <asp:Label ID="lblMessage" runat="server" ForeColor="Red"></asp:Label>
                                    <div class="note">
                                        <img src="/images/forms_proposal/icon/warning.png" width="21" height="18" alt="Note"
                                            style="vertical-align: middle; padding-bottom: 3px" />
                                        <strong>Note</strong>, by clicking on the SUBMIT button you agree to our Website's
                                        <a href="../../terms/Terms.aspx" target="_blank">Terms &amp; Conditions</a>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="bottom"></div>
                    </div>
                </div>
                <div class="seperator"></div>
            </div>
        </div>
    </div>
    
    <div id="footer">
        <div id="nav_bottom" class="pad_7t">
            <div class="left pad_8yr">
                <a href="/travel-insurance/TAresultsquotesOne.aspx" onclick="return confirm('Are you sure to go back?');">
                    <img src="/images/forms_proposal/button/back.png" alt="Back" /></a>
            </div>
            <div class="right pad_8yr">
                <a href="#" onClick="window.print()"><img src="/images/forms_proposal/button/print.png" alt="Print" /></a>
            </div>
        </div>
    </div>
    
    <script type="text/javascript">
        //<![CDATA[
        IncreaseProgress(100);
        HideLoading();
        //]]--> 
    </script>
        
    <script type="text/javascript">

        function ShowHideDiv(divName, varOnOff) {
            if (varOnOff) {
                document.getElementById(divName).style.display = "";
            }
            else {
                document.getElementById(divName).style.display = "none";
            }

        }


        function CheckOptionValidationCss() {
            CheckCardTypeValidationCss();

        }

        function CheckValidationCss(divYes, divNo, ctrlText, valCtrl) {
            ShowValidationEffectOption(divYes, divNo, ctrlText, valCtrl);
            return true;
        }

        function CheckValidationCssThree(div1, div2, div3, ctrlText, valCtrl) {
            ShowValidationEffectOptionThree(div1, div2, div3, ctrlText, valCtrl);
            return true;
        }


        function CheckCardTypeValidationCss() {
            CheckValidationCss('divVisa', 'divMasterCard', '<%=txtCardType.ClientID%>', '<%=rfvCardType.ClientID%>');
        }

        function ValCheckCardType(varOnOff) {
            var txtCtrl = document.getElementById("<%=txtCardType.ClientID%>");
            txtCtrl.value = "1";
        }

        function Check2NRICValid(source, arguments) {
            var ddlicpass = document.getElementById('<%=txtNRICPassInsured.ClientID%>');
            var appicpass = ddlicpass.value;

            var ddlspouseicpass = document.getElementById('<%=txtNRICPassSpouse.ClientID%>');
            var spouseicpass = ddlspouseicpass.value;

            var result = true;
            //alert(applicantNRIC + ' ' + spouseNRIC);

            if (appicpass == spouseicpass && appicpass != '' & spouseicpass != '') {
                result = false;
            }
            else {
                result = true;
            }

            if (result == false) {
                ddlicpass.style.backgroundColor = '#fcc';
                ddlicpass.style.border = 'Solid 1px #f00';
                ddlspouseicpass.style.backgroundColor = '#fcc';
                ddlspouseicpass.style.border = 'Solid 1px #f00';
            }
            else {
                ddlicpass.style.backgroundColor = '';
                ddlicpass.style.border = '';
                ddlspouseicpass.style.backgroundColor = '';
                ddlspouseicpass.style.border = '';

            }
            arguments.IsValid = result;
        }

        function Check2NRICValidFamily(source, arguments) {
            var ddlicpass = document.getElementById('<%=txtNRICPassInsuredFamily.ClientID%>');
            var appicpass = ddlicpass.value;

            var ddlspouseicpass = document.getElementById('<%=txtNRICPassSpouseFamily.ClientID%>');
            var spouseicpass = ddlspouseicpass.value;

            var result = true;

            if (appicpass == spouseicpass) {
                result = false;
            }
            else {
                result = true;
            }

            if (result == false) {
                ddlicpass.style.backgroundColor = '#fcc';
                ddlicpass.style.border = 'Solid 1px #f00';
                ddlspouseicpass.style.backgroundColor = '#fcc';
                ddlspouseicpass.style.border = 'Solid 1px #f00';
            }
            else {
                ddlicpass.style.backgroundColor = '';
                ddlicpass.style.border = '';
                ddlspouseicpass.style.backgroundColor = '';
                ddlspouseicpass.style.border = '';

            }
            arguments.IsValid = result;
        }

        function showhide(el) {

            el = document.getElementById(el);
            el.style.display = (el.style.display == "none") ? "block" : "none";

        }

        window.onload = function() {
            showhide('divDeclaration');
            //showhide('divPaymentMode');
            //showhide('divInsured');

            if (document.getElementById('<%=txtCardType.ClientID%>').value == "1") {
                ShowHideDiv('divPaymentMode', true);
            }
            else { ShowHideDiv('divPaymentMode', true); }

        }


        function restrictToNumbers(e) {
            if ([e.keyCode || e.which] == 8 || [e.keyCode || e.which] == 37 || [e.keyCode || e.which] == 9 || [e.keyCode || e.which] == 39) //this is to allow backspace
                return true;

            if ([e.keyCode || e.which] < 48 || [e.keyCode || e.which] > 57)
                e.preventDefault ? e.preventDefault() : e.returnValue = false;
        }

        function requestByPostCode() {
            try {
                var _pcode = document.getElementById('<%=txtPostCode.ClientID%>').value;
                if (_pcode.length != 6) {
                    alert('Postal code length must be 6 numbers value.');
                    document.getElementById('<%=txtAddress.ClientID%>').value = '';
                    return false;
                }
                else {
                    requestData(_pcode);
                }
            }
            catch (e) {
                alert(e.toString());
            }
        }

        function set_data(json) {
            try {
                var srcTable = $("#divAddress").empty();
                var txtAddress = document.getElementById('<%=txtAddress.ClientID%>');
                if (json == null) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }
                if (json.length == 0) {
                    $("<table><tr><td>No address found!</td></tr></table>").appendTo(srcTable);
                    alert("No address found!");
                    document.getElementById('<%=txtPostCode.ClientID%>').value = "";
                    txtAddress.value = "No Address found.";
                    return;
                }

                var tbl = $("<table width='50%'>");

                var tbody = $("<tbody>");
                var no = 1;
                for (var i = 0; i < json.length; i++) {
                    var trow = $("<tr>"), rec = json[i];
                    if (rec.t != null) {

                        var ctn = rec.t + "<br>" + rec.a;

                        //$("<td>").text(no).data("col", 1).appendTo(trow);
                        $("<td>").html(ctn).data("col", 2).appendTo(trow);
                        if (i == 0) {
                            txtAddress.value = rec.t + "\n" + rec.a;
                        }
                        else {
                            txtAddress.value += "\n\n" + rec.t + "\n" + rec.a;
                        }
                        no++;
                    }
                    trow.appendTo(tbody);
                }
                tbody.appendTo(tbl);
                //alert(srcTable);
                tbl.appendTo(srcTable);
            }
            catch (e) {
                alert(e.toString());
            }
        }

        function PostCodeChange() {
            document.getElementById('divAddress').innerHTML = "Your postcode changed.";
            document.getElementById('divAddress').style.display = 'none';
            document.getElementById('<%=txtAddress.ClientID%>').innerHTML = "Your postcode changed.";
        }
        
    </script>

</asp:Content>